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Flashcards in T4-HIV Deck (39)
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1
Q

HIV causes a weakened immune system by killing what type of cells?

A

CD4 T cells

2
Q

T/F: HIV puts patients at increased risk for certain cancers

A

TRUE

3
Q

What is the technical definition of AIDS?

A

A syndrome in which the individual is HIV+ and has either

  1. CD4 T count below 200 cell/mL OR
  2. Has 2 AIDS defining illnesses

(Pheumocytosis pneumonia, TB, Kaposi Sarcome, discemminated histoplasmosis, cytomegalovirus retinitus)

4
Q

What is ART?

A

Standard antiretroviral therapy

5
Q

How many drugs does ART consist of?

A

3-4

6
Q

What is another name for ART therapy?

A

HAART (highly active antiretroviral therapy)

7
Q

T/F: Current drug therapy (HAART) can decrease plasma HIV to levels that are undetectable with current technology?

A

TRUE

8
Q

ART has reduced age related deaths by ___%

A

72%

9
Q

T/F: Patients compliant with ART can become noncontagious.

A

FALSE; ART does NOT eliminate HIV

10
Q

HIV is a retrovirus. What do retroviruses lack?

A

The machinery needed for SELF-REPLICATION–and thus are OBLIGATE INTRACELLULAR PARASITES

11
Q

How many types of HIV are there?

A

2

HIV1 and HIV2

12
Q

What type of HIV is most common is the US?

A

HIV1

13
Q

What are 2 reasons why HIV replication is massive during the initial phase of infection?

A
  1. Population of CD4 T cells is large! (large breeding ground)
  2. Host has not yet mounted immune system against HIV, so replication can proceed unopposed
14
Q

What is the name for the stage of initially high viral load?

A

Acute retroviral syndrome

15
Q

Why is it essential that clients be treated with a combination of antiretroviral drugs?

A

To minimize the emergence of resistance (same strategy fro treating TB)

16
Q

T/F: Male circumsion can decrease the risk of acquiring HIV sexually?

A

TRUE

17
Q

What are the S&S of acute retroviral syndrome?

A

Flu-like:

  • Fever
  • Lymphadenopathy
  • Pharyogitis
  • Rash
  • Myalgia
  • Headache
18
Q

The average duration that people with HIV are symptomatic is ___.

A

10 years

19
Q

How many antiretroviral drugs do we have at this time?

A

5

20
Q

What are the 5 types of antiretroviral drugs?

A
Reverse Transcriptase Inhibitors
Integrase Strand Transfer Inhibitors (INSTIs)
Protease Inhibitors (PIs)
Fusion Inhibitors
Chemokine Receptor 5 Antagonists (CCR5)
21
Q

Which type of drug is this: Interfere with HIV DNA replication. These do this by either binding to the DNA strand and causing premature termination, or binding to the enzyme that is building the DNA strand.

A

Reverse transcriptase inhibitors (NRTIs and NNRTIs)

22
Q

What type of drug is this: Inhibits the enzyme that initially integrates HIVs DNA into human DNA

A

Integrase strand transfer inhibitors (INSTIs)

23
Q

What type of drug is this: Prevent the maturing of new HIV into its active form

A

Protease Inhibitors

24
Q

What type of drug is this: Block HIV from entering CD4T cells

A

Fusion inhibitors and CCR5 antagonists

25
Q

Which 3 drugs work by inhibiting enzymes needed for HIV to replicate?

A

Reverse transcriptase inhibitors (NRTIs NNRTIs)
INSTIs
PIs

26
Q

Which 2 drugs work by inhibiting HIV entry into cells?

A

Fusion inhibitors

CCR5 antagonists

27
Q

Which antiretroviral were the first used and remain the backbone of therapy today?

A

NRTIs (reverse transcriptase inhibitors)

28
Q

**What are the 5 major adverse effects of the protease inhibitors?

A
  1. Hyperglycemia/diabetes
  2. Increased bleeding i people with hemophilia
  3. Increases serum transaminase (indicates liver injury) and increase lipids (hyperlipidemia)
  4. Fat redistribution
  5. Reduced bone mineral density
29
Q

Most patients take 2 ___ combined with either a __ or __.

A

Take 2 NRTIs combined with a PI or NNRTI

30
Q

Which lab test is a major factor in deciding when to initiate retroviral therapy and when to change the drug regiment?

A

CD4 T cell counts

31
Q

Which lab test is the best measurement available for predicting clinical outcomes?

A

Plasma HIV RNA (viral load)

32
Q

**The goal of therapy is to decrease HIV RNA plasma levels to below what value?

A

An undetectable level–below 20-75 copies/mL of plasma

33
Q

T/F: When a clients plasma HIV RNA is undetectable, they can still transmit HIV to other people.

A

TRUE

34
Q

**The current recommendation is to begin antiretroviral therapy when the CD4 count drops below ___.

A

500cells/mm^3

35
Q

This recommendation of 500cells/mm^3 is ___ that what was recommended in the past.

A

HIGHER- it used to have to drop to 350 cells/mm^3 in the past

36
Q

Oral preexposure prophylaxis can reduce infection risk by ___.

A

44-73%

37
Q

When should post exposure prophylaxis be initiated?

A

ASAP after HIV exposure–preferably 1-2 hours and NO more than 72 hours and should be continued 28 days

38
Q

In the absence of antiretroviral drugs, the rate of perinatal transmission of HIV in the US is ___%

A

25%

39
Q

When zidovudine is given IV to the mother during labor and delivery, and then IV or PO to the infant, the rate of HIV transmission is ______.

A

Essentially zero